Oral & Maxillofacial Surgery

Pre-Prosthetic Surgery

What is Pre-Prosthetic Surgery?

The preparation of your mouth before the placement of a denture (or prosthesis) is referred to as pre-prosthetic surgery. Some patients require minor oral surgical procedures before receiving a partial or complete denture, in order to ensure the maximum level of comfort. A denture sits on the bone ridge, so it is very important that the bone is the proper shape and size. One of several procedures might need to be performed in order to prepare your mouth for a denture including: bone smoothing and reshaping, removal of excess bone, and/or removal of excess gum tissue. At the WK Oral and Maxillofacial Surgery Institute, our surgeons will work with your restorative dentist to ensure that you prosthesis is well-fitting once delivered.

What is Meant by Bone Smoothing and Reshaping?

When teeth are extracted, the underlying bone might be left sharp and uneven. For the best fit of a denture, the bone might need to be smoothened out or reshaped. The smoothing or re-shaping of the bone is called alveoloplasty. At the WK Oral and Maxillofacial Surgery Institute, this alveoloplasty, or bone smoothening, is performed at the same time as any necessary extractions. This is in attempt to prevent “denture sore spots” due to sharp surfaces or edges underneath the new denture. In patients who have already had their teeth removed, but their dentures remain uncomfortable and difficult to use, alveoloplasty may be all that is necessary for the fabrication of a proper-fitting denture.

What is Meant by Removal of Excess Bone?

Some patients have excess bone that needs to be removed before their restorative dentist can fit them with a denture. These excess portions of bone can range in size. If they are small, sometimes they don’t need to be removed, and the denture can simply be fabricated around them. If they are moderate or large in size, their removal will probably be necessary before a denture is fitted. Extra bone on the lip and cheek side of the ridge is called an exostosis. The plural is exostoses. These almost always need to be removed if being fitted for dentures. They are quite routine to remove, and most of the time can be removed at the same time the teeth are extracted.

When this extra bone is found on the inside of the lower ridge next to the tongue, it is called a lingual torus, or tori if more than one exists. These also usually need to be removed before denture fabrication unless they are very small. These are more difficult to remove, and may require another surgical appointment. When found on the roof of the mouth, the extra bone is referred to as a palatal torus. These usually do not have to be removed unless they are quite large or they extend back into the soft palate and inhibit the seal of the denture. These are the most difficult to be removed.

What is Meant by Removal of Excess Gum Tissue?

Sometimes a pre-existing ill-fitting denture can produce extra folds of gum, lip, and cheek tissue. This usually happens when a denture has been worn for a long time and it no longer fits. These extra folds of tissue known as epulis fissuratum or hyperplastic tissue will not allow proper fitting of a new denture, and need to be removed. This procedure always occurs weeks before the denture-making process has begun to allow for proper healing.

What Can I Expect After the Procedure?

You may experience slight pain and discomfort following the procedure once the local anesthetic has worn off. You will be provided with analgesics (pain killers) to help minimize any discomfort. You will also be provided with prescriptions for antibiotics as well as an antimicrobial mouth-rinse. There will be stitches present in the gums and/or palate that will dissolve on their own in a couple of weeks. Very mild swelling may be noted for the first 2-3 days as well. In cases involving the palate, you may be required to wear a soft surgical splint called a Perio-Pack for a few weeks to assist with healing. Most commonly, people report that procedures on their palate often feel the same as a simple pizza burn. Our surgeons will do whatever is necessary to ensure you are as comfortable as possible before, during, and after the procedure(s).